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Record W4408316270 · doi:10.1101/2025.03.09.25323609

A Multicentre Randomised Controlled Trial Assessing the Efficacy of Antimicrobial Prophylaxis for Extracorporeal Shock Wave Lithotripsy in Reducing Urinary Tract Infection (APPEAL): Statistical Analysis Plan and Methodology

2025· preprint· en· W4408316270 on OpenAlexafffund
Philippe D. Violette, Farhad Tondro Anamag, Sameer Parpia, Sara Tornberg, Arto Mikkola, Sakineh Hajebrahimi, Saana Horstia, Borna Tadayon Najafabadi, Jani Ruotsalainen, Pramila Gaudel, Le Mai Tu, Thomas Tailly, Farzin Soleimanzadeh, Hanieh Salehi‐Pourmehr, Mari Saalasti, Patrick O. Richard, Hassan Razvi, Negar Pourjamal, Stephen E. Pautler, Sanna Myrskysalo, Mohsen Mohammadrahimi, Murilo Luz, Samuel Lagabrielle, Pauliina Kuutti, Tuomas P. Kilpeläinen, Petrus Järvinen, Alireza Farshi, Agus Rizal Ardy Hariandy Hamid, D. S. Gorelov, Nariman Gadzhiev, John D. Denstedt, Kathrin Bausch, Raed A. Azhar, Moza Al Hail, Mohamed A. Abd El Aziz, Mohamed Abdelkareem, Gordon Guyatt, Kari A.O. Tikkinen

Bibliographic record

VenuemedRxiv · 2025
Typepreprint
Languageen
FieldMedicine
TopicUrinary Tract Infections Management
Canadian institutionsWestern UniversityCentre Hospitalier Universitaire de SherbrookeUniversity of TorontoMcMaster UniversityImpact
FundersSigrid Juséliuksen SäätiöPhysicians' Services Incorporated FoundationLawson Health Research Institute
KeywordsMedicineExtracorporeal shock wave lithotripsyUrinary systemAntimicrobialAntibiotic prophylaxisRandomized controlled trialLithotripsySurgeryAppealIntensive care medicineInternal medicineAntibiotics

Abstract

fetched live from OpenAlex

Abstract Background Urinary tract infection (UTI) is a recognized complication of shock wave lithotripsy (SWL) for urolithiasis. Evidence guiding antibiotic prophylaxis remains of low certainty, contributing to substantial practice variation and conflicting guidelines. A well-powered, blinded randomized trial is essential to provide trustworthy evidence for clinical practice. Study Design An international, multicentre, randomized controlled trial (the APPEAL trial) assessing the benefits and harms of a single dose of ciprofloxacin versus placebo before SWL in reducing post-procedure UTI. Patients, healthcare providers, data collectors, outcome adjudicators and statisticians blinded to treatment assignment. Endpoints Appeal’s primary outcome is bacteriuria or symptomatic UTI (symptomatic UTI defined as symptomatic cystitis, pyelonephritis, or urosepsis) within approximately 7-14 days post-SWL. Other outcomes include pyelonephritis or urosepsis, and serious adverse events. Patients and Methods Over 1,500 patients from high- and middle-income countries undergoing SWL for nephrolithiasis or ureterolithiasis. Exclusion criteria include a positive pre-SWL urine analysis for nitrites or urine culture, ongoing or planned antibiotic use, suspected struvite stones, urinary catheters or diversion, or a history of urosepsis. Imminent report of APPEAL will provide high-quality evidence on the role of antibiotic prophylaxis in SWL and identify subgroups that may benefit most. Trial Registration ClinicalTrial.gov identifier (ID): NCT03692715 .

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.005
metaresearch head score (Gemma)0.005
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Randomized trial · Consensus signal: Randomized trial
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.271
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0050.005
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.083
GPT teacher head0.381
Teacher spread0.297 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designRandomized trial
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2025
Admission routes2
Has abstractyes

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